<style>
ul li{ list-style:none;}
.htthanhtoan-box{ width: 855px; height:380px; background:#FFF; margin:auto;}
.title-htthanhtoan{background:#a7e36c; height:39px; margin-bottom:5px;}
.title-htthanhtoan span{color:#5d5d5d; font-size:20px; display:block; padding-top:6px; padding-left:13px; float:left;}

.htthanhtoan-btn {
    background: url(../images/login-btn-bg2.png) no-repeat; width:138px; height:42px;
    border-radius: 3px 3px 3px 3px;
    color: #707070;
    cursor: pointer;
    font-size:18px;
    padding: 2px 10px 8px 5px;
    text-align: center !important;
	border:none;
	margin-top:15px; margin-bottom:15px;
	float:right; margin-right:19px;
}
.content-htthanhtoan .customer-info{margin-left:18%;}
</style>

<div class="htthanhtoan-box">
	<div class="title-htthanhtoan">
    	<span>Thông tin khách hàng</span>
    </div>
    <div class="content-htthanhtoan">    	
        <div class="customer-info">        	
            <ul class="form-list">
            	<li class="field">
                	<label> Họ tên<em>*</em></label>
                    <input type="text" class="" id="name" name="" title="Họ tên" />
                </li>
                <li class="field">
                	<label> Email<em>*</em></label>
                    <input type="text" class="" id="email" name="" title="Email" disabled="disabled" />
                </li>
                <li class="field">
                	<label> Điện thoại<em>*</em></label>
                    <input type="text" class="" id="phone" name="" title="Điện thoại" disabled="disabled" />
                </li>
                 <li class="field">
                	<label> Tỉnh thành<em>*</em></label>
                    <select style="width: 260px; height:27px; margin-top:12px;" id="provinder" name="provinder" title="Tỉnh thành"> 
                    	<option value="1"> Nam</option>
                        <option value="0"> Nữ</option>
                    </select>
                </li>
                 <li class="field">
                	<label> Địa chỉ<em>*</em></label>
                    <input type="text" class="htthanhtoan-input" id="address" name="" title="Địa chỉ" />
                </li>  
                 <li class="field">
                	<label> Email người giới thiệu</label>
                    <input type="text" class="" id="email" name="" title="Email" />
                </li>
            </ul>
             <a href="#ttkhachhang" class="login-window"><button id="htthanhtoan-btn" name="htthanhtoan" title="Tiếp tục" value="" class="htthanhtoan-btn" type="submit"><span>Tiếp tục</span></button></a>
        </div>
        <div class="clear"></div>
        
    	
    </div>   
</div>